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Medicine Robotics Technology

Machine Repairs Injured Human Livers and Keeps Them Alive Outside the Body For One Week (sciencedaily.com) 36

Researchers from the University Hospital Zurich, ETH Zurich, Wyss Zurich and the University of Zurich have developed a machine that repairs injured human livers and keeps them alive outside the body for one week. ScienceDaily reports: Until now, livers could be stored safely outside the body for only a few hours. With the novel perfusion technology, livers -- and even injured livers -- can now be kept alive outside of the body for an entire week. This is a major breakthrough in transplantation medicine, which may increase the number of available organs for transplantation and save many lives of patients suffering from severe liver disease or a variety of cancers. Injured cadaveric livers, initially not suitable for use in transplantation, may regain full function while perfused in the new machine for several days. The basis for this technology is a complex perfusion system, mimicking most core body functions close to physiology. The corresponding study was published in the journal Nature Biotechnology.

The inaugural study shows that six of ten perfused poor-quality human livers, declined for transplantation by all centers in Europe, recovered to full function within one week of perfusion on the machine. The next step will be to use these organs for transplantation. The proposed technology opens a large avenue for many applications offering a new life for many patients with end stage liver disease or cancer.

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Machine Repairs Injured Human Livers and Keeps Them Alive Outside the Body For One Week

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  • With the novel perfusion technology, livers -- and even injured livers -- can now be kept alive outside of the body for an entire week.

    ... the novella perfusion technology can be used.

    [I know the sentence was directly from TFA, but it really should be "with this novel ... technique" -- just sayin'.]

  • by silentbozo ( 542534 ) on Wednesday January 15, 2020 @02:56AM (#59622400) Journal

    https://www.wysszurich.uzh.ch/... [wysszurich.uzh.ch]

    This tech is apparently designed to allow someone with a diseased liver to have a small but healthy portion removed, kept alive in the machine so that it can grow outside the body, and then be reimplanted once it has grown large enough to replace the diseased portions that couldn't be removed without killing the patient.

    If it works, it's way better than a transplant from someone else.

    • by fintux ( 798480 ) on Wednesday January 15, 2020 @03:16AM (#59622432)

      The article you linked also says:

      This novel regeneration strategy could also be used in allogenic liver transplantation (patient receives liver tissue from a donor) for end-stage chronic liver disease, where an organ transplant is the only treatment option. In this second approach, a healthy donor liver will be split into a couple of parts that will be grown in the perfusion machine, yielding more than one transplantable organ.

      Even just one of these options would be great. With both of these, it's amazing! I hope this will be saving numerous lives and not be too costly so that it will be widely available.

      • I think you're understating how amazing this has the potential to be.

        Right now it's already very successful in a limited first trial on human livers. (They did a bunch on pig ones leading up to this.) It still is a prototype. It hasn't undergone a bunch of revisions. There is so much more improvement that can be done, and it's already mindblowingly awesome.

        The future possibilities are incredible and world-changing. If they can figure out how to do it without removing your liver, you could go in for a week f

    • by gweihir ( 88907 ) on Wednesday January 15, 2020 @03:34AM (#59622456)

      Nope. What they currently have done is get 6 of 10 livers declined for transplantation because of poor quality (so they could have them) up to what they think is transplantation quality in that one week. They basically get a 1 week window to attempt to treat a liver outside of the body and to fix it if possible. I have no idea how many livers are non-viable for transplantation initially, but it seems to be a real source of additional organs.

      The really interesting thing is however that this project required close cooperation between MDs, biologists and engineers. And that seems to have been a real challenge.

    • If it works, it's way better than a transplant from someone else.

      Or you could just stop drinking so much alcohol.

    • by az-saguaro ( 1231754 ) on Wednesday January 15, 2020 @08:33AM (#59622812)

      Actually - no.

      The problem with organ transplantation is that most organs come from cadaveric donors. There are transplants done from living related donors, where, say your sister, donates a compatible kidney or liver segment. In that scenario, the donor organ is healthy and gets from donor to recipient in a matter of minutes. Thus the organ is healthy and should start to function promptly.

      However, for most transplants, organs come as anatomical gifts from people who have died, often violently and unexpectedly. By the time that demise of the patient is evident and that organ donation is a possibility, the donor is pretty beat up physiologically speaking, and the organs to be transplanted are feeling the adverse effects of all of that physiological trauma. What was an otherwise healthy organ to start with is now feeling the effects of "shock liver" or inflammation or thrombosis, making it unusable - that is the conundrum of the situation, these organs come from dying people, and a lot of physiology has gone awry, damaging the organs.

      Furthermore, for living donors, in which donor and recipient are in adjacent operating rooms with two teams of surgeons, there are no delays, and a liver or kidney will stay alive for the brief period required without blood perfusion. But, for cadaveric transplants, organs come from a rather sophisticated network system that can deliver organs across the country within hours. But, "hours" is too long for living organs, so we need methods to preserve the organ in a viable state. These methods are either refrigeration to slow metabolism or else pump perfusion to maintain an artificial blood flow of sorts.

      Take an organ that is already physiologically damaged by the nature of the donor's injury, hemorrhage, shock, and attempted resuscitation, and add to that matching and transportation time delays, and a potentially useful organ becomes garbage. Being able to maintain longer perfusion is crucial. Even more intriguing is the possibility that the organ could live outside of its original host more or less normally, surviving the 7 days required for physiological recovery after shock-trauma, thus healthy and ready to function properly when placed in a new host.

      This is all easier said than done. Maintaining prolonged liver viability has been a challenge since liver transplants started in the 1970's. These authors have finally cracked that nut. If clinically successful, and it sounds like it is destined to be, then livers which come from healthy donors, but which have been rendered unusable by the circumstances of the patient's death, or else the logistics of getting to the recipient, will now have a chance to recover ex vivo from the original owner so that in 7 days the organ is eligible to be used in a recipient.

      It is a really good paper - go read it.
      https://www.nature.com/article... [nature.com]

    • by Matheus ( 586080 )

      That was my thought reading the summary glad to know they're already thinking of it.

      Transplantation is great and glad this helps but the real win is the ability to temporarily extract people's own organs, repair / regenerate them, and re-implant.

      The liver is more suited for processes like these better than most if not all but the eyes but hopefully similar techniques could be used for other organs as well!

      The Future: "Wow it's been a decade already?? Time for my decennial organ refresh!"

  • I'm guessing not having to do the hard work of cleaning toxins from the body allows it to regenerate much more quickly than it otherwise would. I wonder if one day they will ultimately be able to remove a diseased liver from the body and keep the patient alive with dialyses while the liver regenerates.
    • I wonder if one day they will ultimately be able to remove a diseased liver from the body and keep the patient alive with dialyses while the liver regenerates.

      Or... they could just keep the patient away from alcohol for a week.

      • Or Tylenol, or Lipitor, which can also damage the liver by accident, especially if accidentally overdosed?

        Chronic cirrhosis from alcohol is a health problem, and difficult to recover from for addicts. But let's be fair, someone who overdoses on Tylenol for chronic pain deserves more sympathy, and better pain management.

        • Why do they deserve more sympathy? Have you ever seen an alcoholic?

          In school, they told us the brain grows a special gland in alcoholics that makes them hyper-respond. I suspect the brain just kicks the nucleus accumbens into serious overdrive and every part of their existence starts screaming "BOOZE GOOD GIVE MORE!!!!" They sure as hell struggle to control their drinking.

  • Are those livers still staying healthy and functioning aftet transplantation?

    Or is it only temporary, and they will degrade again in some way?
    (Similar to how managers love to push losses to next year and earnings to the current one, to make things look good until they got their new better job and bonus.)

    If this truly works, congratulations!
    The liver isn't an easy one, given ist key role.
    I wonder if similar total simulation of all chemicals, neural signals and such can be used on other organs. Maybe, some da

  • by Headw1nd ( 829599 ) on Wednesday January 15, 2020 @08:51AM (#59622850)
    Unfortunately the designers cannot yet control which livers it extracts, repairs, and stores, and they have so far been unsuccessful in their attempts to shut it down.
  • I'll drink to that!

  • I’ll drink to that!
  • Too late for Hank the Angry Drunken Dwarf, sadly.

  • by chill ( 34294 ) on Wednesday January 15, 2020 @12:34PM (#59623392) Journal

    Today I learned that "perfused" means "bathed in a mixture of Chianti and fava beans".

  • Too bad they can't yet perfuse the whole human.

  • When will I be able to get my meat like this? Kept living until just before being cooked.

A committee takes root and grows, it flowers, wilts and dies, scattering the seed from which other committees will bloom. -- Parkinson

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